Department of Oral and Maxillofacial Diseases, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
Division of Nephrology, Department of Medicine, Helsinki University Hospital, Helsinki, Finland.
Oral Dis. 2020 Jul;26(5):1045-1052. doi: 10.1111/odi.13296. Epub 2020 Feb 19.
Association was investigated between oral health before dialysis and the incidence of systemic infections during dialysis. We hypothesized that low-grade systemic inflammation caused by poor oral health associates with infectious episodes in patients on dialysis, despite earlier eradication of oral infection foci.
A total of 117 patients (46 with peritoneal and 71 with hemodialysis) were examined and treated at predialysis stage and followed up during dialysis. Number of infection episodes and microorganisms cultured from blood and peritoneal fluid were analyzed. Number of teeth, periodontal inflammatory burden, and total dental index scores were assessed, and salivary matrix metalloproteinase 8, triggering receptor on myeloid cells 1, peptidoglycan recognition protein 1 (PGLYRP1), and interleukin-1β were measured.
In hemodialysis, 134 infection episodes were recorded, while peritoneal dialysis group had 77 peritonitis episodes. Culture-negative samples were 69% in hemodialysis and 23% in peritoneal dialysis group. Staphylococci were the most frequently associated microorganisms. Infections during dialysis did neither associate with oral health parameters nor associate with salivary inflammatory biomarkers, except for PGLYRP1, which associated with number of infection episodes during hemodialysis (p = .046).
A number of infection episodes during hemodialysis were associated with salivary PGLYRP1 but not the other salivary markers or oral infection markers.
研究透析前口腔健康与透析期间全身感染发生率之间的关系。我们假设，尽管口腔感染灶已被早期清除，但由口腔健康不良引起的低度全身炎症与透析患者的感染发作有关。
共检查和治疗了 117 名患者（46 名腹膜透析患者和 71 名血液透析患者），并在透析前阶段进行了检查和治疗，并在透析期间进行了随访。分析了感染发作次数和从血液和腹膜液中培养的微生物。评估了牙齿数量、牙周炎症负担和总牙指数评分，并测量了唾液基质金属蛋白酶 8、髓样细胞触发受体 1、肽聚糖识别蛋白 1（PGLYRP1）和白细胞介素-1β。
血液透析中记录了 134 次感染发作，而腹膜透析组有 77 次腹膜炎发作。血液透析组中 69%的样本培养为阴性，腹膜透析组中 23%的样本培养为阴性。葡萄球菌是最常与微生物相关的微生物。透析期间的感染既与口腔健康参数无关，也与唾液炎症生物标志物无关，除了 PGLYRP1，它与血液透析期间感染发作的次数相关（p=.046）。
血液透析期间发生的感染次数与唾液中的 PGLYRP1 相关，但与其他唾液标志物或口腔感染标志物无关。
